From mystery to mechanisms: Functional symptoms and modern brain science

The term persistent physical symptoms (PPS) is an emerging umbrella label for medically unexplained symptoms, somatisation, or functional illness. Modern brain science now shows how these symptoms are generated and sustained through powerful brain–body interactions at an unconscious level. Transdiagnostic mechanisms include altered perceptual processing (‘predictive coding’), autonomic dysregulation, and conditioned responses.

While this science may sound complex, the good news is that a biopsychosocial model offers a practical way forward. It enables each patient to identify predisposing, precipitating, and perpetuating factors that shape their illness experience.

Randomised controlled trials now support the thoughtful use of trans-symptomatic approaches, often centred on patients’ own active self-management.

Increasing numbers of recovery narratives also illustrate how modern explanations can be a ‘game-changer’ for both patients and their doctors.

Speaker: 
Hamish Wilson  
GP and Associate Professor

Hamish Wilson is a GP and Associate Professor at Otago Medical School. With Dr Wayne Cunningham, he wrote "Being a Doctor: Understanding Medical Practice" (2013), a text that explored some of the ongoing clinical challenges for GPs and other clinicians. He has been researching and writing about somatisation or persistent somatic symptoms for many years, focusing on the lived experiences of both patients and their doctors.

His current focus is helping to translate recent neuroscience insights about such symptoms into practical clinical skills and educational initiatives. 

Hamish's talk is supported by: